Immune Checkpoint Inhibitors and Beyond: An Overview of Immune-Based Therapies in Merkel Cell Carcinoma

American Journal of Clinical Dermatology - Merkel cell carcinoma (MCC) is an aggressive skin cancer. Until 2017, patients with advanced disease were typically treated with conventional...     

Cytokines (IL-6, IL-8, TNF): early and reliable predictors of severe acute pancreatitis

BACKGROUND: Severe acute pancreatitis is associated with a high mortality, especially when compared with mild acute pancreatitis. Early intervention in patients with severe acute pancreatitis has been shown to improve mortality. The value of cytokines (interleukin [IL]-6, IL-8 and tumor necrosis factor [TNF]-alpha) in diagnosing severe acute pancreatitis at an early stage was studied. STUDY: Thirty-six patients with acute pancreatitis were prospectively evaluated. Age-matched controls were obtained from healthy volunteers. Levels of IL-6, IL-8, and TNF-alpha were obtained within 24 hours of admission. Ranson's prognostic signs and Bank's clinical criteria were used to differentiate patients into mild and severe pancreatitis. RESULTS: There was significant difference in IL-6 levels between controls and mild pancreatitis, controls and severe pancreatitis, and mild and severe pancreatitis. IL-8 levels were significantly different between controls and severe pancreatitis and mild and severe pancreatitis. There was no significant difference between controls and mild pancreatitis. The results for TNF-alpha were similar to the findings for IL-8. CONCLUSION: IL-6, IL-8, and TNF can be used independently in differentiating mild acute pancreatitis from early severe acute pancreatitis.     

Evaluation of the efficacy of a prosthodontic stent in determining the position of dental implants

Purpose: To evaluate the efficacy of a dual purpose (diagnostic and surgical) acrylic resin stent with gutta percha marker used in conjunction with 3D imaging in determination of the position and inclination of dental implants. Materials and Methods: This study was performed as a case control study. A total of 41 implants, of which 20 had been placed without the use of stents and 3D imaging (control group) and 21 were placed using stents and 3D imaging (study group), were studied. A diagnostic and surgical stent with radio‐opaque indicator (gutta percha) was fabricated to determine the planned prosthetic position and inclination of the implant. Computed tomography images were obtained and were analyzed using Denta Scan software. The position of the implant was analyzed in mesiodistal and buccolingual dimensions in terms of both position and angulation. SPSS v15.0 was used for statistical analysis (p < 0.05 was considered statistically significant). Results: The study group demonstrated an overall 98.9% efficacy of the test technique being used in the study. On qualitative assessment, the results obtained were within the defined ideal threshold level for four of five parameters (distance from buccal and lingual cortical plate, inter‐implant distance, and buccolingual angulation of the implant relative to underlying alveolar bone). For mesiodistal distance from adjacent teeth, the observation was not above threshold value for only one case. For the control group, the overall efficacy was 66.9%. Conclusion: The technique of combined use of a prosthodontic stent and 3D imaging is an efficacious and better technique in achieving an ideal position of dental implants as compared to conventional techniques using periapical and panoramic radiographs and a cast.     

Non-invasive management of fused upper incisors

The union of two different dental sprouts which can happen in any phase of dental development is commonly called fusion. This developmental anomaly may cause clinical problems including esthetic impairment, which are mainly treated by endodontic and surgical treatments. There are a few reports of conservative not invasive treatment of fused incisors teeth through restorative or prosthetic techniques. They are rarely reported in mandibular posterior teeth. This paper presents an unusual case of fusion of 7 and 8, and also 9 and 10 teeth which was treated with a nonendodontic and nonsurgical conservative approach. Patient was a healthy18-year-old female with chief complaint of bad-looking teeth that in intraoral examination revealed the fusion of 7 and 8, and also 9 and 10 teeth. The space between the mesial of the 6 and 11 teeth was reconstructed. Diastema between the fused teeth was closed. A new lateral tooth was replaced between the fused teeth (7 and 8) and 6 tooth with direct fiber-reinforced composite. The space between the fused teeth (9 and 10) and also tooth 11 was partially closed. Gingival papillas were reconstructed using pink composite. The mandibular anterior missing teeth were replaced with rochett bridge. At the end of treatment the esthetic of the patient was improved. As the treatment was not invasive, major complications are not expected; however, there is potential for eventual long-term periodontal problems due to poor oral hygiene. Debonding of the rochett bridge may happen as well.